Clinical Neurosciences Center
New National Study Shows Utah's Hospitals Are Best in Nation at Getting Stroke Patient Life-Saving Clot-Busting Drugs
SALT LAKE CITY – Utah has the nation’s highest percentage of stroke patients who receive clot-busting drugs within 60 minutes of their arrival in a hospital emergency department, according to new study by the American Heart Association/American Stroke Association.
The new study measured “door-to-needle” time, or the amount of time it takes to give eligible stroke patients an intravenous dose of recombinant tissue plasminogen activator, known as rt-PA, which dissolves the blood clots in the brain that cause a stroke.
The study organized the data in a state-by‐state comparison based on the percent of patients with door-to-needle times under 60 minutes.
In Utah, the study found that 62 percent of patients in 2012 received rt-PA within 60 minutes, dramatically better than the national average of 43 percent, and significantly better than the any other state.
Stroke experts from Intermountain Healthcare, University of Utah Health Care and the Utah Hospital Association will outlined the study in detail, and discussed how hospitals in Utah are working to improve Utah’s stroke response times even more.
Stroke is the third leading cause of death in Utah and the leading cause of serious, longterm disability.
The data are especially timely during May, which is National Stroke Awareness Month, which is designed to encourage people to understand the symptoms of stroke and how to respond.
The study found that the next highest states (and the percent of patients who receive rt--‐ PA within 60 minutes), behind Utah are:
- Colorado: 61.7 percent
- Minnesota: 58.5 percent
- Oklahoma and West Virginia (tie): 54.7 percent
The data was collected from the over 800 U.S. hospitals that participate in the AHA/ASA stroke-specific quality-improvement program, “Get with the Guidelines.” In Utah, 17 hospitals participate with this program, including large hospitals (which are typically certified as Primary Stroke Centers) and smaller hospitals (typically designated as Stroke Receiving Facilities).
The data reflect the statewide average percent of patients receiving rt-PA in under 60 minutes and doesn’t differentiate between the individual rates of hospitals.
“Intravenous rt-PA is the standard of care for ischemic stroke patients — it’s the best way to treat them and the best way to limit the long-term disabilities from stroke,” says Jennifer Majersik, MD, director of the Stroke Center at University of Utah Hospital and past chair of the Utah State Stroke Task Force. “The faster you get it, the sooner it works, and the more likely you are to recover from a stroke.”
Stroke neurologist Kevin Call, MD, medical director of the stroke development team for Intermountain Healthcare, and chair of the Utah State Stroke Task Force, adds: “You never want to experience a stroke, but the data suggest that if you’re going to have one, Utah is the best place to be in the nation. This is the result of hospitals throughout Utah working toward one common goal — to provide the fastest, best possible care for patients.”
Speed is crucial when a stroke occurs because delays normally result in greater loss of brain function. To recognize a stroke, remember the acronym FAST:
Face — Does one side droop?
Arms — Does one arm drift downward?
Speech — Are words slurred or mispronounced?
Time — Time is very important – call 911 now!
“It’s important for people to remember that if you see someone experiencing just one of these symptoms, even if the symptom goes away, call 911 immediately ,” says Dr. Call.
National best-practice guidelines include these steps for patients who are suffering from acute ischemic stroke: Perform the initial patient evaluation within 10 minutes of arrival in an emergency department.
- Notify the stroke team within 15 minutes of arrival
- Perform a CT or MR scan within 25 minutes of arrival
- Interpret the CT or MR scan within 45 minutes of arrival
- Start IV rt-PA immediately after the scan is interpreted - within 60 minutes of arrival.
It’s estimated that someone in the United States suffers a stroke every 45 seconds; someone dies of a stroke every three minutes; and 795,000 people suffer a new or recurrent stroke each year.
Primary Stroke Centers in Utah include Intermountain Medical Center in Murray, Jordan Valley Medical Center in West Jordan, McKay-Dee Hospital Center in Ogden, Ogden Regional Medical Center, Pioneer Valley Hospital in West Valley City, St. Mark's Hospital in Salt Lake City, University of Utah Medical Center in Salt Lake City, and Utah Valley Regional Medical Center in Provo.
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